Men who have sex with men (MSM) and transgender people in Cambodia are at high risk of HIV. Studies have reported an HIV prevalence of 5.1% in MSM, compared to 0.8% in the general population.
“Most MSM are hidden and reluctant to show their identity as it invites stigma from their community and family”, says Chin Bunrath, a team leader who works with the MSM and transgender community. Tackling the issues of stigma and discrimination and reaching MSM and transgender people with prevention services are key to combating HIV.
TARGETING PEOPLE AT HIGHER RISK
With the help of EC funding, KHANA, the Alliance Linking Organisation in Cambodia, supported prevention projects which target key populations at higher risk of HIV. One NGO that KHANA supports is Men’s Health Social Service (MHSS) for their program in Kampong Chhnang province.
Through peer educators and facilitators MHSS reached out to the MSM and transgender community with education sessions on preventing HIV, referring individuals to voluntary counselling and testing services, and following up with advice on income generation. Chin Bunrath was a team leader for MHSS, and organised this work. “The target group were interested in access to free health services and free condoms because MSM who were poor could not afford those services” he says.
Dr. Nhen Chantha is the STI Clinical Director at Kompong Chnang hospital. He has noticed the difference this work made “Since the project has been implementing activities we have received almost weekly visits from MSM coming to our office.”
One of the people who the project has reached is Hout Sotha, a 27 year old transgender woman. “My life is much better today” she says. “We have changed some bad attitudes and we always use condoms when we have sex. When we have medical problems we go directly to the health centre for services”. Hout has also been helped to improve her business, with a grant from KHANA and MHSS. She runs a small beauty salon shop and used the grant to purchase new equipment.
MHSS’s work isn’t just about reaching MSM and transgender people. They also aim to change attitudes of the wider community to make a real impact on reducing stigma and discrimination. They do this through working with local authorities and by organising special events and campaigns that target communities.
While there is still a long way to go to eradicate stigma and discrimination, the work so far has had a clear impact for Hout, “Most people in our community now do not discriminate against us…Now I and my friend can go anywhere with full confidence” she says.
The EC project ran from 2007-2011. KHANA continues to work with MSM and transgender people with funding through USAID and the Global Fund. Individuals under the previous EU program have been transferred to other programming support.
KHANA is now tailoring services to reach hidden and hard to reach groups and segmenting services for different types of MSM and transgender people. KHANA is also ensuring regular HIV testing, earlier detection of HIV cases, and referrals to care and treatment for people living with HIV.
This article was based on a case study written by Mok Sokha, a member of the Key Correspondents team in Cambodia. You can download the full case study here.